Quiet launch for Dey's new respiratory drug

NAPA, Calif. - Dey Laboratories launched its newest respiratory medication, Perforomist, Oct. 8, but providers, wary of reimbursement upheavals over the last several quarters, are lukewarm on the product. "We're going to try Perforomist because it's got a better shelf life," said Sam Jarczynski, president of RxStat in St. Petersburg, Fla. "But the drug is very expensive and the profit is so little. We have to have so much cash outlay on the drug that we are not promoting it. We'll have it to fill if the doctor scripts for it." Billed as a long-acting treatment meant to be taken twice daily, the drug is comparable to Sepracor's Brovana, which launched April 1 (See HME News, July 2007). Both drugs are currently billed under the same miscellaneous code (J7699), but Nov. 5, Sepracor announced it had received a unique code for Brovana (J7605), effective Jan. 1, 2008. Current reimbursement is around $4.85 per dose, estimated Mickey Letson, president of Decatur, Ala.-based Letco Companies. "I don't expect that much play on either product until after the first of the year," said Letson. "When you bill under these miscellaneous codes, especially on expensive drugs like these, it takes forever to get paid." Compounding the issue: stringent requirements before patients can even be tried on either drug. Providers must show documentation that the patient has first tried and failed with a fast-acting rescue bronchodilator, like albuterol, before they can get a prescription for a long-acting drug. That could further dissuade providers from offering the drug, said Wayne Vega. "There's no question that with the lack of profitability--in conjunction with the criteria needing to be met and its potential to be rejected--it's unlikely a Medicare-reimbursed entity would be enthusiastic about supplying the product," said Vega, a consultant with Stat Vial in Acadiana, La. Despite the potential barriers to dispensing, everyone agrees the drug is clinically sound. "The concept of a long-acting bronchodilation in conjunction with anti-inflammatory steroids is the optimum way to treat COPD," said Vega.